Increased overall exposure of the Brazilian population to fluoridated water and fluoridated dentifrices has been identified as the main factor in the reduction of caries prevalence. Thus, the objective of the present study was to evaluate the distribution of caries in a group of 437 children ranging from 6 to 12 years of age, residing in a city without a water supply fluoridation system and without a preventive dentistry program, with the aim of orienting future health measures towards improved cost-effectiveness. Clinical examination was performed on all the children, focusing on the indices defs (decayed, extracted, and filled primary dentition surfaces) and DMFS (decayed, missing, and filled permanent dentition surfaces), representing the number of dental surfaces that were either decayed, missing or with extraction indicated, or restored. Analysis of accumulated disease frequency in relation to the population showed that 37% of the children presented 70% of all the tooth disease, with a mean defs + DMFS of 28.6. This distribution demonstrates the phenomenon of polarization, in which most of the disease and treatment needs are concentrated in a small portion of the population.